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SI Joint problems and solutions after fusion?

coyotewildwomanccoyotewildwoman Posts: 130
edited 06/11/2012 - 9:00 AM in Chronic Pain
I have had a number of spinal surgeries and now a fusion. I have lots of SI pain now from that fusion.. I guess that is common.. I am wondering what other people have used as possible solutions? I still have chronic pain and it seems focused on my right SI joint now which is a new thing after my fusion .. Thoughts and experiences??? Also, Any word on cloned disc material research or developments that helps with DDD etc..

Thanks in advance,



  • We're in the same boat unfortunately. My SI joint is also causing me extra pain (right side) on top of the usual chronic back pain I experience daily anyway (and have done for the past 7 or so years). I remain on medication for it all. I didn't realise either that this is quite a common problem.

    The only thing that my surgeon can do for me now is to give me steroid/anaesthetic injections into the SI joint - so I'm currently on the waiting list. The last time I had an injection, I only got 24 hours pain relief from it, so I'm obviously really hoping the next round will provide much longer pain relief.

    I don't know what else they can do. I'm in the UK and my surgeon does not operate on SI joints (i.e. he does not do SI fusions). He mentioned that, in his experience, this type of operation could cause more problems than it fixes in the long term and, to be honest, I do not want any more spine operations, ever!

    I had revision surgery in December 2011 as my surgeon wanted to address the SI pain by replacing the screws and rods etc., he was hoping this would 'fix' me, but unfortunately, my SI pain has worsened since then. The SI pain was confirmed through various palpation tests, Faber's and diagnostic injections (which I had in May last year).

    My surgeon explained to me that after having the 2-level fusion (2010), it is common for all weight-bearing - which is usually absorbed by the discs themselves in the first place - gets by-passed and then transfers to the next available joint (i.e. the sacro-iliac). I suppose that makes sense.

    Sitting at 90 degrees is a real problem for me and I usually take a cushion wherever I go. Also, if I'm laying in bed on my side it becomes more painful, so my sleep is often disturbed either way (because if it isn't this pain that wakes me up, it's my lower back pain). The SI pain feels like a knife is digging into my buttock and sometimes it goes down my leg. I also get horrendous 'cocyx' pain if I attempt to sit for too long at 90 degrees, and that area goes completely numb. It confuses me that if that area goes numb, why does it hurt so much? I don't know. The pain is just horrible sometimes, and when I stand up I look like a little old lady!

    I've seen cushions with the cocyx cut-out advertised, but I haven't bought one yet. I do not know if it would be more beneficial than the one I already have.

    I do hope you can find something that gives you more pain relief and, if you do, perhaps you can share it with us too?
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Hi Wendy, I had a fusion of the L2,3,4&5 Oct.2010. I did well for about 6 months then I started having the stabbing pain in my right buttock and into my hip and down my leg. I have had 3 SI injections in the last 5 months. My last injection which was only two weeks ago has already quit helping. Of course I have lortab, celebrex and flexeril for pain but I can't take anything while working other than the celebrex. I actually found this website while searching SI joint problems. My insurance will only cover 3 injections a year so I guess I will have to suffer from now till next year. I was told that most ins. companies cover up to six a year. Funny, I work at a hospital and our ins. covers less than most. Hopefully we can both find help on this forum to help us with our struggle. At least it's some comfort to talk to others who have the same things going on as I do.
  • Hi Sue and Wendy,

    I am fused L1 to S1 and after the fusion of L5/S1 last year I started to have problems with my SI joint. A big block of bone sitting on top of it can create problems. My SI joint was kind of a mess to begin with from the accident that caused all this, it was where it all started so it has come full circle.

    I am not excited about having 2 more fusions and the recovery time for SI joint fusions is long - non weight bearing for up to 8 weeks for each side.

    Right now I am controlling the pain with neurontin and Tylenol 3 plus an anti-inflammatory and muscle relaxer. I had cortisone injections last summer and they served as diagnostic as well as pain relieving. Altho the pain was never gone long enough I did have 2 of them because that is the gold standard for determining SI joint pain. If you get relief then you know it is the SI.

    It has limited what I can do. I was able to get back to many of my regular activities after my fusions (I have had 3) but the SI is really keeping me from doing a lot of things. Such is the trade off for correcting the problems with my spine and getting rid of those pain issues.

    There is not much research or many people who have had SI joint fusions. I did chat with someone on this forum who had it done and said they really didn't lost any range of motion. That is what I am really worried about. I am fused so much already.

    Good luck and keep us posted.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • TLIF last June @ L5S1 and SI joints were on fire starting around Oct.

    PT folks suggested an SI belt.

    Got one from Amazon and it helped a bit.

    SI injections did not help.

    In the long run mine was from FBSS. (just diag'd)

    So my SI and L4L5 was getting beat up by the hardware pushing and pulling due to the fusion failure / pseudoarthrosis.

    Looking at a 2 level revision surgery now.

    Try the belt, ~$30 USD on Amazon. I got the black one with Velcro on each side.

    Good !uck :-)
    Jun 2011 -TLIF @L5-S1
    Mar 2012 -NonUnion @L5S1
    May 2012 -Multi Level Discography
    July 2012 -XLIF 2Cages @L3L4/L4L5
    Aug 2012 -All New Hardware @L34L45/L4L5/L5S1
    Mar 2013 -FBSS = Pain Management until they figure it out.
  • Sorry to hear about the failed surgery. What will your revision surgery entail??

    I have had an SI belt for many years. Sometimes I think it works, sometimes I don't.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Removal of all hardware, clean out of old cage and BMP, and then 6 new screws, two cages and 4 bars. Two in back and one on each side for lateral support.

    Then a whole lot of praying and walking only ;-)
    Jun 2011 -TLIF @L5-S1
    Mar 2012 -NonUnion @L5S1
    May 2012 -Multi Level Discography
    July 2012 -XLIF 2Cages @L3L4/L4L5
    Aug 2012 -All New Hardware @L34L45/L4L5/L5S1
    Mar 2013 -FBSS = Pain Management until they figure it out.
  • Will they re-fuse just L5/S1??

    And yes a whole lot of walking. I bought a pedometer after my first of 3 fusions just to keep track.

    Do you have a surgery date yet??

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Yes a redo of L5S1 as well...Remove old hardware cages, BMP, etc.

    I have been using a FitBit to track my steps ...and lack of sleep due to pain ...for months.

    Still need to see what comes of the L4L5 discogram first.
    Jun 2011 -TLIF @L5-S1
    Mar 2012 -NonUnion @L5S1
    May 2012 -Multi Level Discography
    July 2012 -XLIF 2Cages @L3L4/L4L5
    Aug 2012 -All New Hardware @L34L45/L4L5/L5S1
    Mar 2013 -FBSS = Pain Management until they figure it out.
  • I wish I had known this was such a common problem. I really didn't have many options at the time, but this SI joint is really causing me much pain. I feel like the scar tissue locks up and just won't release. I am trying an belt which I just got, and daily massage to break some of this scar tissue up. It gets like a rock. I have thought about a nerve block but I am so physically and emotionally drained at the thought of another painful procedure. And I seem to just get more pain from surgery, injections,etc..

    Based on my current pain journal records, the relief I seem to get now is with Tiger Balm, a glass of bubbly in the evening, my belt ( sometimes yes, sometimes it bugs me) my neurostimulator, frequent massages to my very tight lower back, and IT bands down my leg, the massage roller bar, pilates, not too much walking or too little ( whatever the heck that means, it seems to change daily), dry weather with no change in barometer, no bending over to pick up stuff, don't carry anything over 15 pounds, sitting with a cushion always, mediation, relaxing and not getting stressed.

    Literally what a pain!! I am more than my pain, but boy, what an incredible diva my back has become!

  • I am on Amazon's TigerBalm auto re-order program :-)

    They need to make it in a paint can so I can roll it on ;-)

    My exerperiance with SI joints is transference syndrom from hardware above.

    Mine only goes nuts when I do PT, which stopped after I got diag'd with FBSS / Pseudoarthrosis. Since 10 months out I have no fusion the hardware is working over-time and since I am L5S1 it makes my SI joints go nuts.

    With no PT and just walking it went back to regular bad back pain and neuropathy, but the SI's quieted down a bunch.

    Jun 2011 -TLIF @L5-S1
    Mar 2012 -NonUnion @L5S1
    May 2012 -Multi Level Discography
    July 2012 -XLIF 2Cages @L3L4/L4L5
    Aug 2012 -All New Hardware @L34L45/L4L5/L5S1
    Mar 2013 -FBSS = Pain Management until they figure it out.
  • So I am 31 had my first fusion at L5/S1 after a year they realized I hadnt fused so they did it again, Since then they found out Im not fusing again. Am having the normal pain down my leg and sharp pain in the si joint. I had a mri and was told there was alot of scar tissue(could be the source of pain) I had mild scolisis and medium buldge at L4 level, My X rays make my back look crooked, I've had the injections and did a trial for the SCS but it wasnt for me.......Im currently waiting for a hearing infront of a judge for ssd....That being said anyone have any advice for me....I know I have to deal with this so I try and stay positve, Im a mans man but alot of nights I cry thinking how much of a burden this has been for my family, I have 3 little ones and I just wish I could run around with them, I know you all understand all your post strike home with me, any advice would be greatly appreciated .
    Thanks Steve
  • Damn the scar tissue. If I could sell it I would be rich. It just messes up everything. I don't think it is the cause of my SI issues as the surgeon says it is being caused by being fused L1-S1 above it.

    I was controlling the pain with the cocktail of drugs on my profile but that is no longer effective. I see the surgeon wed to figure out what is next. I have had all the other procedures done, won't list them, are in my profile also.

    I am fearing it will be another fusion and the SI joint fusion is so much more than the others as far as recovery. Just as pain doesn't fit our lifestyles being non weight bearing for 6-8 weeks and being single doesn't exactly fit in with my summer plans, if that is what should happen.

    I wish I had some good advice for you. Can you work on the scar tissue to see if you can break it up. Mine is hard as a rock (too many surgeries) but I still do friction massage a couple of nights a week. I don't know it it helps or not but the placebo affect here may work. If I think it is helping...

    I would be interested to see how your SSD is going and just what the process is. I may be doing that sooner rather than later.

    The only thing is to find something positive about the day and it is sometimes hard to do even that. I don't like looking at the big picture because that is bleak. But if I have a good swim or I could work in the yard for a few minutes, whatever.

    Maybe there are new things you can learn to do with your little guys that can help you feel more involved. Obviously it won't be the same but focus on what you can do.

    I know its easy to say but I went from finishing 2nd in the Ironman Triathlon World Championships in Hawaii to not being able to walk more than a short distance and can't ride my bike either. But I can still swim. All from getting knocked unconscious from an out of control snowboarder who destroyed my back and SI. So I try not to focus on what I have lost because it is gone for good. Its hard.

    Please keep me posted on how you are doing and how your SSD goes.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • Went to the Dr and was told there was nothing more that could be done, I will be treated with medicine and will have restrictions of no lifting over 10lbs no bending or twisting and rotate standing and sitting. He said I have a strong case for SSD, and a candidate for voc rehibiltation. Just dont know how Im going to be able to do more than I am now which mostly consist of going in pain for an hour and lying on a heating pad for a couple. But the sun will still shine tomorow and I know I have to keep my head up and to try and live life as best I can. Praying I get SSD for my family. Any feedback would be appreciated and hope you all manage the best you can and not get to down.
  • I am currently working with a deep tissue massage therapist and I stretch out constantly.

    She is coming twice a week, and I may have her come more. I am evaluating all of my wellness therapies right now and am keeping a journal.

    Her massages hurt but I feel the best I ever do the next day.

    I know I have tons of scar tissue after 5 surgeries.

    I am also take lots of anti inflammatory supplements like tumeric, ginger, flax seed oil, fish oil, and eat an anti inflammatory diet. Avoid wheat etc.

    I know lots of my pain is from inflammation and the scar tissue. But everyone is different.

    So based on lots of research on my part- I am a research junkie and it is what I do for a living, it is important to focus on what is needed for your body and symptoms.

    We are all very different, and as we have new injuries and/or surgeries what works may also change. I know it has for me.

    I refuse to do more surgery as it just seems to create more scar tissue. I wish I could create money like I create scar tissue!


  • I agree with you if scar tissue was money we would all be rich!!

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
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